Molecular and Genetic Profiling of Serrated Colorectal Tumours
Research type
Research Study
Full title
Molecular and Genetic Profiling of Colorectal Tumours in patients with Serrated Polyposis Syndrome
IRAS ID
221656
Contact name
Salman Rana
Contact email
Sponsor organisation
London Northwest University Healthcare NHS Trust
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
The traditional model of colorectal cancer development was based around the ‘adenoma-carcinoma’ sequence, where pre-cursor adenoma type polyps undergo a number of genetic changes to form cancer in the large bowel. It has long been recognized however, that up to 30% of sporadic cancer develops through an alternate pathway with its origins in a different type of polyp known as the ‘serrated’ polyp. This pathway remains poorly understood. In 2000 the World Health Organisation defined the serrated polyposis syndrome (SPS) to identify people with large numbers of serrated polyps. These patients and their first degree relatives have a much higher risk of cancer development. The consensus from most of the important studies to date show that cancers in this group occur in the elderly population and are seen to be more prevalent in the right colon.
A recent review of patients with known SPS at St. Marks has shown that 20% have developed colorectal cancer to date. Contrary to current understanding, more than half of these cancers were seen in patients under the age of 60. Moreover, almost 70% are found in the left side of the colon and rectum.
In order to understand this phenomenon better, we aim to analyse these cancers for a number of molecular and genetic markers. This will help us to profile each tumour to see if they truly fit what we currently known to be the ‘serrated’ subset of cancer. It has been shown that the risk of cancers in SPS is higher when traditional adenomas are also present. It may actually be the case that SPS cancers are arising from these adenoma which are growing concurrently with serrated lesions. We also intended to compare and contrast the profiles of cancer that we see in the young versus the older population.
REC name
North West - Haydock Research Ethics Committee
REC reference
17/NW/0274
Date of REC Opinion
4 May 2017
REC opinion
Favourable Opinion